Analysis Of Influencing Factors On Recurrence Of Femoropopliteal Arteriosclerosis Obliterans After Interventional Therapy

Objective To explore the influencing factors of postoperative recurrence in patients with femoral popliteal lower extremity arteriosclerosis obliterans and its predictive value for postoperative recurrence.Methods This study is a retrospective study.Clinical data of 96 patients with femoritpopliteal lower extremity arteriosclerosis obliterans who received interventionary treatment in the Department of Interventionary Vascular Pain of Hefei Second People’s Hospital from May 2018 to February 2020 were collected.The patients were followed up for 2 years after surgery in the clinic and by telephone to evaluate the patency of blood vessels in the affected limbs.According to the patency of blood vessels,the patients were divided into recurrent group and non-recurrent group.The preoperative clinical laboratory indicators and imaging data of the two groups were analyzed by univariate analysis to find the difference indicators between the two groups.In order to fully include the indicators that may affect the prognosis of patients,the indicators with a difference of P < 0.1 between groups and those that may be risk factors in previous studies were all included into the multi-factor binary Logistic regression equation to analyze the independent influencing factors of postoperative recurrence of femoral popliteal lower extremity arteriosclerosis obliterans.With postoperative recurrence as the outcome index,the analysis variables of the ROC for single influencing factors were drawn,and the predicted value P was calculated by binary Logistic regression with the enter method,and the combined ROC curve was drawn.To predict the risk of recurrence after intervention and find the optimal threshold.Results The recurrence rate 2 years after interventional therapy was 44.8%(43/96).Univariate analysis of TASC Ⅱ,monocyte,erythrocyte distribution width,glucose,cystatin C,homocysteine were the risk factors for postoperative recurrence(P < 0.05).Statistical difference of leukocyte,neutrophil and mean erythrocyte volume P < 0.1could be included in multiple Logistic regression equation.Multivariate binary Logistic regression showed that TASC Ⅱ classification(OR=3.334,95%CI 1.579-7.039,P=0.002)cystatin C(OR=3.108,95%CI 1.149-8.406,P=0.025)was an independent risk factor for postoperative recurrence.Mean erythrocyte volume(OR=0.895,95%CI 0.806-0.995,P=0.040)was an independent protective factor.The ROC curve of TASC Ⅱclassification,cystatin C and average RBC volume was drawn with recurrence after intervention as outcome index,and the area under the curve was all less than 0.7,indicating poor diagnostic efficacy.The area under the combined ROC curve was 0.776,the diagnostic efficiency was significantly improved,the sensitivity was 73.8%,the specificity was 78.0%,the 95% confidence interval was 0.680～0.873,and the P was less than 0.000.It is suggested that the accuracy of predicting relapse after interventional operation is high.Conclusion TASC Ⅱ classification,monocyte,erythrocyte distribution width,glucose,cystatin C and homocysteine are risk factors for recurrence after interventional ASO of lower extremity.TASC Ⅱ classification and cystatin C are independent risk factors for recurrence after interventional ASO of lower extremity,and average erythrocyte volume is independent protective factor.The combination of the above indexes can produce certain prognostic value for patients’ prognosis.